Syria Crisis: MSF’s Emergency Response

October 1, 2012

Since the crisis began in Syria in March 2011, the ability for international organisations, including Médecins Sans Frontières (MSF), to provide aid inside Syria has been severely restricted. Despite difficulties accessing the country, MSF has been working in Syria for the past three months, trying to provide humanitarian assistance to people affected by the conflict. MSF has also strengthened its response to the refugees who are flowing across the Syrian borders into countries such as Lebanon, Jordan and Iraq.

Inside Syria:

Treating the wounded

MSF has been working on the ground in Syria since June. With the help of the Union of Syrian Medical Relief Organisations, in six days a team was able to transform an empty house into an emergency hospital, where wounded people could be operated on and hospitalised.

As of mid-September, MSF has admitted more than 1100 patients to this facility and carried out 350 surgeries. The injuries have been largely conflict-related and caused mostly by tank shelling and bombing. Many patients have suffered gunshot wounds.

The majority of the patients have been men, but up to one-in-ten are women, and approximately one-in-five are under the age of 20. According to the medical team, two-thirds of the procedures were emergency surgeries.

However, the future of the project is uncertain. In addition to the fact that MSF is working without authorisation from the Syrian authorities, our activities are under threat by the changing nature of the conflict, difficulties accessing supplies, and the challenges the injured face in reaching the hospital.

Considering the level of violence that is rife in Syria today, the MSF team, comprising national and international staff, is only able to provide a limited amount of medical support. This assistance is nonetheless essential for the survival of the people treated at the hospital.

Aside from the surgical project, MSF has donated a shipment of relief items and medical supplies to the Syrian Arab Red Crescent in Damascus. The donated supplies complement tons of medical supplies and relief items MSF has dispatched to field hospitals and clinics over the past year.

MSF is also organising relief operations for displaced people in the north of Syria, by providing water and organising sanitation.

Responding to medical needs of Syrian refugees in Lebanon

Meanwhile in Lebanon, MSF has expanded its activities to provide urgent assistance to the tens of thousands of refugees who have fled from neighbouring Syria. MSF has opened new medical projects in the north of Lebanon in the Wadi Khaled area, in Tripoli, and also in various locations in the Bekaa Valley. From March to September this year, MSF medical staff conducted more than 11,600 general healthcare consultations, and psychologists and psychiatrists carried out 1,700 consultations.

Many of the refugees are living in overcrowded conditions, fearful for their safety, suffering psychological distress and unable to afford medical care.

In June 2012, MSF carried out a survey to understand the living conditions and health needs of the refugees and the major issues facing them. Many of the refugees are living in overcrowded conditions, fearful for their safety, suffering psychological distress and unable to afford medical care. Most refugees are settling in economically disadvantaged regions of Lebanon, placing an additional burden on already overstretched resources. Gaps are appearing in refugees’ access to medical care, particularly hospital care and treatment for chronic diseases.

“The refugees are really being tested,” said Fabio Forgione, MSF’s head of mission in Lebanon. “When they arrive, most are struggling to deal with the consequences of direct violence and loss; then they have to face the reality of not being able to go home. Many lose all hope.”

Of the 5,000 refugees interviewed by MSF, three-quarters fled Syria as a direct result of the conflict and 40 percent have lost family members to the violence. The majority say they have not found the security they sought. Lebanon is itself unstable as a result of the Syrian crisis, evidenced by recent violent tensions in the country’s second city, Tripoli.

Feelings of hopelessness and alienation are widespread. Nine out of 10 people interviewed see their future as highly precarious and do not know if they will be able to return home.

As more and more Syrians cross into Lebanon, living conditions for the refugees are deteriorating.

“There are severe overcrowding problems in Wadi Khaled in northern Lebanon and in Aarsal in Bekaa Valley, while in Tripoli, rental costs are beyond what they can afford,” said Forgione.

Most Syrian refugees in Lebanon rely on humanitarian assistance, which is now coming under threat. So far, the combined support of host communities, the government, and humanitarian organizations has averted a major health crisis. Individuals within the Lebanese community have made tremendous efforts to integrate and help the refugees, but financial constraints are limiting what they can do. Reductions in assistance could put the refugees’ health in danger.

Providing surgery for wounded Syrians arriving in Jordan

Refugees fleeing the conflict in Syria are also arriving in Jordan every day. They follow different routes but almost always end up in one of the refugee camps set up at the border crossing in the Jordanian town of Ramtha.

For many of the refugees who arrive wounded and requiring medical attention, a specialized MSF surgical team performs operations in a hospital in nearby Amman. An MSF doctor comes to Ramtha every few days to determine whether any of the new arrivals are in need of surgery.

At present, the MSF reconstructive surgery project in Amman is admitting about 50 injured Syrians a month.

Initially, the MSF team in Amman performed only reconstructive surgery, treating victims of violence from Iraq, Libya, Yemen, and other countries. However, the number of Syrian refugees arriving in Jordan with bullet wounds and other injuries has grown steadily since the revolt broke out in their country.

As a result, MSF has strengthened its orthopedic surgery team. An MSF surgeon examines five to ten patients weekly at the hospital, about one-third of whom require orthopedic surgery. Another third receive physical therapy and the remaining third are monitored. X-rays are performed regularly to observe their fractures.

“On the other hand,” says Dr. Mohamed, a member of the MSF team, “people who are in very serious condition remain inside Syria and can’t make it here.”